Scientists show they can use electronic medical records and birth information to verify and strengthen an already suspected link between autistic children and pregnant mothers with obesity and diabetes.
The findings from researchers at Cincinnati Children’s Hospital Medical Center are reported in a study posted online ahead of publication by the journal Autism Research. An estimated one out of 45 children is affected by autism spectrum disorder (ASD). Both genetics, environment and the interaction of both are suspected. The increasing prevalence of ASD also happens to mirror increases in obesity and diabetes, the authors note.
“Although previous studies report a link between maternal obesity and diabetes during pregnancy to autism, we demonstrate that electronic medical data can verify and establish the extent of this link across large populations,” said Katherine Bowers, PhD, MPH, study senior author and a member of the Division of Biostatistics and Epidemiology at Cincinnati Children’s.
“Without placing any burden on study participants or the costs of developing an epidemiologic study from scratch, we can use the vast amounts of data already collected for clinical purposes to conduct broad population-based studies on this link to autism. We are very excited about the future studies we can do with this ability,” she added.
According to study data, pregnant mothers with obesity or gestational diabetes were 1.5 times more likely to have a child with ASD compared to mothers of children without developmental disorders. The increased risk of ASD for pregnant mothers with both obesity and gestational diabetes was two-fold. The findings fit well into an increasing body of evidence that obesity and gestational diabetes may be associated with the development of autism.
Including collaborators in the Division of Biomedical Informatics at Cincinnati Children’s, Bowers and her colleagues analyzed a variety medical record and birth data from patients and mothers to help identify risk factors. Using birth records from Southwest Ohio (part of the Cincinnati Children’s primary service area) the researchers compared mothers who had a child diagnosed with ASD to mothers of children with a non-autism developmental disorder. They also included in their comparison mothers with children having no developmental disorders.
The authors said they were fortunate to have access to a large number of electronic medical records from the Cincinnati Children’s Kelly O’Leary Center for Autism Spectrum Disorders, a leading autism diagnosis and treatment center with a rigorous, uniform, and multidisciplinary autism assessment process. Unlike prior studies, the researchers were able to use novel language processing techniques to analyze free text medical notes and confirm autism diagnoses expressed as a numerical code.
Among study participants, 487 mothers had a child with ASD, 1,495 had a child with another type of developmental disorder, and 35,734 mothers of children without ASD or a developmental disorder were included for control. The average age of mothers having children with ASD was 28.6 years, and 27.4 years for both mothers of children with a developmental disorder and for controls.
Given the increased prevalence of children with autism spectrum disorders, they stress the importance of using their findings collaboratively to conduct much larger multi-institutional studies.
About this autism research
Funding: Funding support for the study came in part from an Institutional Clinical and Translational Science Award and the National Institutes of Health/National Center for Advancing Translational Sciences (8UL1TR000077-04).
Source: Nick Miller – Cincinnati Children’s Hospital Medical Center Image Source: The image is in the public domain Original Research: Full open access research for “Maternal metabolic risk factors for autism spectrum disorder—An analysis of electronic medical records and linked birth data” by Natalia Connolly, Julia Anixt, Patty Manning, Daniel Ping-I Lin, Keith A. Marsolo and Katherine Bowers in Autism Research. Published online January 29 2016 doi:10.1002/aur.1586
Maternal metabolic risk factors for autism spectrum disorder—An analysis of electronic medical records and linked birth data
Past studies have suggested that conditions experienced by women during pregnancy (e.g. obesity and gestational diabetes mellitus (GDM)) may be associated with having a child with autism spectrum disorder (ASD). Our objective was to compare mothers who had a child diagnosed with ASD to mothers of children with a non-ASD developmental disorder (DD) or without any reported DD (controls). To accomplish the objective we collected medical record data from patients who resided in the Cincinnati Children’s Hospital Medical Center’s (CCHMC) primary catchment area and linked those data to data from birth certificates (to identify risk factors). Two comparison groups were analyzed; one with DD; and the other, controls without a reported ASD or DD. Descriptive statistics and regression analyses evaluated differences. Differences were greater comparing mothers of ASD to controls than comparing ASD to DD. Maternal obesity and GDM were associated with a statistically significant approximately 1.5-fold increased odds of having a child with an ASD. For mothers with both GDM and obesity, the association was twofold for having a child with ASD compared with controls. Maternal obesity and GDM might be associated with an increased risk of ASD in the offspring; however, no difference in risk of ASD according to BMI and GDM was seen when comparing to DD.
“Maternal metabolic risk factors for autism spectrum disorder—An analysis of electronic medical records and linked birth data” by Natalia Connolly, Julia Anixt, Patty Manning, Daniel Ping-I Lin, Keith A. Marsolo and Katherine Bowers in Autism Research. Published online January 29 2016 doi:10.1002/aur.1586